Janssen RS, Holtgrave DR, Valdiserri RO, et al. The Serostatus Approach to Fighting the HIV Epidemic: prevention strategies for infected individuals

Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
American Journal of Public Health (Impact Factor: 4.55). 08/2001; 91(7):1019-24. DOI: 10.2105/AJPH.91.7.1019
Source: PubMed


In the United States, HIV prevention programs have historically tailored activities for specific groups primarily on the basis of behavioral risk factors and demographic characteristics. Through the Serostatus Approach to Fighting the Epidemic (SAFE), the Centers for Disease Control and Prevention is now expanding prevention programs, especially for individuals with HIV, to reduce the risk of transmission as a supplement to current programs that primarily focus on reducing the risk of acquisition of the virus. For individuals with HIV, SAFE comprises action steps that focus on diagnosing all HIV-infected persons, linking them to appropriate high-quality care and prevention services, helping them adhere to treatment regimens, and supporting them in adopting and sustaining HIV risk reduction behavior. SAFE couple a traditional infectious disease control focus on the infected person with behavioral interventions that have been standard for HIV prevention programs.

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    • "First, MSM were defined as participants who self-identified as gay or bisexual, therefore straight-identifying MSM, a group arguably considered to be even more at-risk, were not included. Data from elsewhere suggest that MSM on the " down low " are even more stigmatized and may not engage in care, suggesting our findings to be conservative (Janssen et al., 2001 "
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    ABSTRACT: The US HIV/AIDS epidemic is concentrated among men who have sex with men (MSM). Black men are disproportionately affected by incarceration and Black MSM experience higher infection rates and worse HIV-related health outcomes compared to non-Black MSM. We compared HIV treatment outcomes for Black MSM to other HIV-infected men from one of the largest cohorts of HIV-infected jail detainees (N = 1270) transitioning to the community. Of the 574 HIV-infected men released, 113 (19.7%) self-identified as being MSM. Compared to other male subgroups, young Black MSM (<30 years old, N = 18) were significantly less likely: (1) before incarceration, to have insurance, access to an HIV healthcare provider, and use cocaine; (2) during incarceration, to receive a disease management intervention; and (3) in the 6 months post-release, to link to HIV care. Interventions that effectively link and retain young HIV-infected Black MSM in care in communities before incarceration and post-release from jail are urgently needed.
    Full-text · Article · Aug 2015 · AIDS Care
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    • "Many attribute this disparity in HIV incidence to the high number of unrecognized HIV infections among Latino and Black MSM [3], [7]. Detection of HIV infection is important for individuals because knowledge of infection status has great implications in sexual risk management, forward transmission, treatment linkage, and quality of life [8]. "
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    ABSTRACT: Introduction Rates of unrecognized HIV infection are significantly higher among Latino and Black men who have sex with men (MSM). Policy makers have proposed that HIV self-testing kits and new methods for delivering self-testing could improve testing uptake among minority MSM. This study sought to conduct qualitative assessments with MSM of color to determine the acceptability of using electronic vending machines to dispense HIV self-testing kits. Materials and Methods African American and Latino MSM were recruited using a participant pool from an existing HIV prevention trial on Facebook. If participants expressed interest in using a vending machine to receive an HIV self-testing kit, they were emailed a 4-digit personal identification number (PIN) code to retrieve the test from the machine. We followed up with those who had tested to assess their willingness to participate in an interview about their experience. Results Twelve kits were dispensed and 8 interviews were conducted. In general, participants expressed that the vending machine was an acceptable HIV test delivery method due to its novelty and convenience. Discussion Acceptability of this delivery model for HIV testing kits was closely associated with three main factors: credibility, confidentiality, and convenience. Future research is needed to address issues, such as user-induced errors and costs, before scaling up the dispensing method.
    Full-text · Article · Jul 2014 · PLoS ONE
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    • "We should also note the power of naming a concept; just as negotiated safety had crystallized the idea of gay men's risk reduction strategies within relationships, raising the visibility of Australian social research, the naming of serosorting focused attention on risk reduction by gay men with casual partners and highlighted U.S. behavioral research. The labelling of serosorting in the U.S., its quasi-epidemiological name, and its heavy reliance on accurate knowledge of HIV status encouraged U.S. researchers to investigate it at a time when the U.S. Centers for Disease Control and Prevention were pushing a serostatus approach to the epidemic that heavily emphasized mass HIV testing (Janssen et al., 2001). "
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    ABSTRACT: Since the mid-1980s, Australian social researchers have investigated the sexual practices of gay men, describing those that protect men from HIV or put them at risk of infection. Ground-breaking (and controversial) publications have highlighted a variety of ways in which gay men protect themselves and their partners, including condom use and non-condom-based risk reduction strategies. HIV social research in Australia has been heavily influenced by a distinctive network of experts or epistemic community with shared principles and beliefs and a commitment to influencing policy and practice. This epistemic community has articulated a 'social public health' view of HIV that emphasises partnership, agency, understanding practices and reflexivity. This approach has clashed with those of other epistemic communities, notably around ideas of relapse and unsafe sex. This article uses the examples of negotiated safety and serosorting to illustrate this Australian epistemic community's approach to HIV risk reduction among gay men.
    Full-text · Article · Jun 2014 · AIDS education and prevention: official publication of the International Society for AIDS Education
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